'COVID has shattered actuarial science': Incoming Clover Health CEO lays out his priorities, challenges

Clover Health President and Chief Technology Officer Andrew Toy will assume the role of CEO in January when founder Vivek Garipalli moves on from the position. 

"I kind of joke that I would like to think of myself as the only computer scientist running a managed care company," Mr. Toy told Becker's

This will not be Mr. Toy's first time in a CEO role. He is a co-founder and former CEO of Divide, a company that focused on creating a split between work and personal data on mobile devices. The company was acquired by Google in 2014. 

Mr. Toy, who has been at Clover since 2018, said he sees himself as a managed care leader at this point, "just with a really deep technology background." 

He recently spoke with Becker's about his priorities, biggest challenges and leadership experience. 

Note: This interview was lightly edited for length and clarity. 

Question: What is your top priority as CEO? 

Andrew Toy: We're very, very focused now on profitability, profitable growth and sustainable operations. What I mean by that is we have proven our technology platform lets us work with a large number of doctors on a PPO in Medicare Advantage, which is not the norm. We have proven we can grow well, well above industry norms because of that because we believe people want to choose their own doctor and we've been rewarded with that growth because we offer something others don't. … That we have strong medical care ratios, strong sustainable economics, while offering top-of-the-line products, while still growing, is my focus now for the next couple of years. 

Q: What is the biggest challenge you're facing right now?

AT: At our heart, we're an insurance company. We're very technology-centric, but we're an insurance company at our heart. Insurance is built upon predictability. The past should predict the future. That's how insurance actuarial science works. What no one is talking about right now is the fact that COVID has shattered actuarial science. There's no way to predict your 2023 on the basis of your 2020, 2021, even your 2022. Why would those years predict the future? Put another way, you don't want those years to predict the future. Those are the years with all the pandemic in them. So now is a very unusual time — not just for Clover but for the whole industry — because I think everyone was so used to the predictability and the rhythm of the healthcare arc that having the pandemic break is not something that people are used to in our industry. I think Clover is well-equipped for that because we see everything as new anyway, but it's very hard, I think, for the traditional managed care companies. 

Q: This is not your first time serving as the CEO of a company. What did you learn from that previous experience that will help you hit the ground running?

AT: What's similar is I'm used to being in the chair. What I mean by that is, using an old saying, "the buck stops at the CEO." I'm not worried about the fact that total accountability ends with you — I mean you are accountable to the board — I'm comfortable with that. That's the same no matter what company you're CEO of, no matter how big it is. You being the apex of the pyramid and not really having someone to go to is very familiar. I think that is something that's different for a lot of first-time CEOs. 

What's going to be different at this stage is obviously I've never been public before, but I've helped take this company public. I've done a lot of the earnings [calls], I think I feel comfortable running a public company at this point. 

The last dimension I think will be a little bit different is certainly the way healthcare people think is different and running a healthcare company is different in terms of the kind of people you work with. It's been a very slow-moving industry for a very long time and balancing what's reasonable to expect in healthcare along with our big aspirations at Clover, that's a little different. In technology you're expected to try and transform everything every day. In healthcare, that's not expected. That's more what we want to do. And balancing that, I think that's going to be new. 

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